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Rehabilitation Practice and Science

Abstract

Background: This study aimed to investigate the effects of a lidocaine patch on peripheral nerve conduction.

Methods: Fifteen healthy volunteers with no symptoms or signs of neuropathy in either upper limb were recruited for this double-blind, placebo-controlled study over a 10-month period. A lidocaine patch or a placebo patch was applied to the volar aspect of the wrist during sleep. The treatment procedure was repeated for 14 consecutive nights. Nerve conduction studies were performed and analyzed at each assessment point. All participants were re-evaluated, with electrophysiological studies of the median and ulnar nerves repeated at 1 week and 2 weeks after the baseline measurement.

Results: No statistically significant changes were observed in the nerve conduction parameters—including distal latency, nerve conduction velocity, and amplitude of the evoked potential—following lidocaine patch treatment, except for the sensory nerve conduction velocity (SNCV) of the distal segment of the median nerve.

Conclusion: Local application of a 5% lidocaine patch for two weeks resulted in a significant increase in the sensory nerve conduction velocity of the distal median nerve. This finding may be explained by the potential selective blockade of smaller-diameter nerve fibers (Aδ and C fibers) by lidocaine, leaving the larger, faster-conducting Aβ fibers relatively unaffected. Consequently, the recorded nerve conduction velocity may appear faster as it primarily reflects the activity of these remaining larger fibers. No significant changes were observed in the other nerves tested. These preliminary findings warrant further investigation in larger-scale studies with longer follow-up periods to confirm the effect and elucidate the underlying mechanisms.

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